Five Tips to De-escalate Conflict as a Hospitalist

As we all know, the job of a hospitalist can be demanding. Resources can often be scarce, communication can be minimal, and clinicians and patients may easily be pushed to extreme levels of stress. This kind of pressure often breeds conflict. In the health care setting, conflict can arise between patients and their care team, caregivers and clinicians, and peer to peer. When unexpected scenarios present themselves, it’s important to remember how to de-escalate them confidently and calmly before they get out of control.

De-escalation is a technique that can help prevent the intensification of a disagreement. When confronted with aggressive behavior, you can use the process of de-escalation to bring resolution in a healthy way. As a hospitalist, you may likely experience conflict with patients and their caregivers, especially if a patient is near the end of life. It’s important to remember that reacting poorly during these encounters will likely only make the issue worse.

The following tips may provide useful information for practicing the process of de-escalation:

1. Step Away
   Hospital rooms can often incite a lot of anxiety for patients and their caregivers. During a conflict, it may be helpful to move to a quiet and neutral location (if it’s safe to do so for the patient and/or caregiver) away from the hospital room to discuss the issue at hand.
   
2. Show Compassion
   It’s important to show that you care, especially when a patient or their caregiver has a concern. Valid or not, by confirming their feelings are real and offering empathy, the disagreement has a much higher chance of being resolved from the start when you are compassionate.
3. Practice Good Nonverbal Communication
   Even if you are upset and having a hard time controlling your emotions, your body language should remain neutral. Crossing your arms, looking at your watch, frowning, invading personal space, and avoiding eye contact are all examples of negative body language. Instead, try to maintain eye contact, use minimal facial expressions, maintain a relaxed posture, and keep your arms to your side with your palms open.
4. Set Your Own Boundaries
   If you are dealing with someone who is belligerent, it will be difficult to talk rationally. One way to diffuse the situation is to set boundaries that offer respectful consequences. An example of this would be to ask the patient or caregiver to please speak courteously before continuing the conversation. If this cannot be accomplished, you can offer to come back later at a time when they are ready and willing to be calm and polite.
5. Don’t Rush Major Decisions
   One of the quickest ways to get into an argument is to make a patient or caregiver feel that they must make a quick and hasty decision. Unless it is medically necessary (for example in the case of an emergency), try to give the patient or caregiver a few minutes to process their decision and let them know you understand the difficulty of the matter and are there to help with answering any questions they may have.

Executing these recommendations can help health care professionals build trust with patients and caregivers and encourage a safe work environment. We hope you never find yourself in a conflict, but hope you are well equipped to handle the situation should it occur.

Want more information about conflict resolution? Let us know and we will be happy to share even more best practices from our health care team.

Learn More About Advanced Care Hospitalists (ACH)

ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. Our providers are highly skilled, board-certified internal medicine specialists who are available around-the-clock to meet the care needs of patients from hospital admission through discharge. Post-discharge from the hospital, we continue overseeing patient care for 30 days.

We’ve found that continued care coordination ensures more accurate medication reconciliation, improved compliance with discharge plans, better scheduling of follow-up visits, and fewer hospital readmissions. Our providers do everything in their power to make sure our patients receive the compassionate and comprehensive care they need to promote healing and prevent a second hospital admission.

For more information about our services and our practice, please contact Advanced Care Hospitalists at 863-816-5884 or fill out a contact form online.